Metabolic syndrome is a complex of risk factors for cardiovascular disease and type 2 diabetes. The most widely recognized of the risk factors are atherogenic dyslipidemia, elevated blood pressure and elevated plasma glucose. In addition, patients with these characteristics commonly manifest a prothrombotic state and a proinflammatory state. Atherogenic dyslipidemia consists of an aggregation of lipoprotein abnormalities that includes elevated serum triglyceride and apolipoprotein B, increased small low-density lipoprotein particles and a reduced level of high-density lipoprotein cholesterol. Most patients with metabolic syndrome also have abdominal (central) obesity and insulin resistance. For general background on metabolic syndrome factors and diagnosis, see Alberti et al., Circulation, 120:1640-1645 (2009).
Metabolic syndrome is common and has a rising prevalence worldwide, which relates largely to increasing obesity and sedentary lifestyles. Patients with the metabolic syndrome are at twice the risk of developing cardiovascular disease over the next five to ten years as individuals without the syndrome. The risk over a lifetime undoubtedly is even higher. Furthermore, the metabolic syndrome confers a five-fold increase in risk for type 2 diabetes mellitus. Metabolic syndrome is now both a public health and a clinical problem, and there is clearly a need for new and effective treatments for metabolic syndrome.